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Combination therapy for breast cancer
By Mayo Clinic staffMany women with hormone receptor positive cancer cells receive both chemotherapy and hormone therapy. With regard to cancer recurrence, combination therapy may provide a greater benefit to some women than does chemotherapy alone.
However, some controversy exists surrounding combination therapy. Researchers found certain subsets of women with hormone receptor positive breast cancer benefit more from chemotherapy plus hormone therapy than do others. For those who don't stand to benefit as much, chemotherapy presents a grueling treatment regimen, with great risk of side effects and not much benefit. If you're one of these women, you may be better off with adjuvant hormone therapy alone.
This is where a gene test on the cancer cells could be helpful. Newly developed tests use gene expression — a technical term for how active particular genes are — to help oncologists make diagnoses and predictions about how well a chosen therapy may work. Some experts believe that such testing can help identify the subset of women who stand to benefit the most from combination therapy. Currently, such testing mostly applies to women with estrogen sensitive (estrogen receptor positive) breast cancer that has not spread to the lymph nodes (node negative). However, research is under way regarding use of gene expression tests in women with estrogen sensitive, node positive breast cancers.
Side effects of combination therapy
Combination therapy carries a greater risk of blood clots than does tamoxifen alone. The most common side effects are premature menopause, weight gain and fatigue. Several smaller studies have suggested that mild memory problems (chemo brain) may result from combination therapy. The treatment also puts you at a very small increased risk of uterine cancers (endometrial cancer and uterine sarcoma) and congestive heart failure.
